arXiv subjects

Andriy Myronenko

Publications and source records attributed to Andriy Myronenko.

At least 19 recordsLinked to original sources

arXiv2026

BaT: Towards Self-Evolving Medical Research Agent with Stage Rubrics

Long-horizon agents are beginning to automate complete workflows that produce code, reports, and research artifacts. Medical imaging workflows are multi-stage and data-sensitive, while expert trajectories remain scarce and difficult to share. Structured benchmarks can localize failures through stage-level rubrics, but standard post-training discards these diagnostics before the next training round. We present Benchmark-as-Teacher (BaT), a recursive self-improvement system for agent post-training. BaT contains two linked components: the asynchronous Stage Bank data pipeline and BiCuRL (Bilevel Curriculum Reinforcement Learning), its self-improving post-training method. Stage Bank synthesizes content-isolated training states outside the policy-update loop. BiCuRL uses a fixed held-out evaluation to select the next stage curriculum, verifies rollouts with task rubrics, updates the policy with GRPO, and returns the candidate checkpoint to evaluation. On AutoMedBench-Lite, BaT-4B and BaT-9B more than double the Overall scores of their Qwen Instruct baselines. BaT-9B Agent reaches 79.6 Overall, exceeding Claude Opus 4.6 with Claude Code at 77.5.

cs.AI↗

arXiv2026

AutoMedBench: Towards Medical AutoResearch with Agentic AI Models

Autonomous agents are increasingly expected to support end-to-end medical-AI research workflows, moving beyond isolated prediction tasks or short-form clinical question answering. However, existing medical agent benchmarks primarily evaluate final outputs, providing limited visibility into agent behavior within the research process. To address this gap, we present AutoMedBench, a workflow-aware benchmark for autonomous medical-AI research across diverse medical imaging and multimodal inference tasks, organizing agent execution into a unified five-stage workflow (S1-S5): Plan, Setup, Validate, Inference, and Submit. It comprises long-horizon tasks with each run averaging 33 agent turns, spanning five research tracks: segmentation, image enhancement, visual question answering (VQA), report generation, and lesion detection. Each task is evaluated under two difficulty tiers, Lite and Standard, which use the same data and metrics but differ in the amount of task-brief scaffolding, and each run is scored using both final task performance and S1-S5 stage scores, enabling stage-level analysis from the initial task brief to the final submitted artifact. Across thousands of recorded runs, stage-level scoring reveals that Validate is the weakest workflow stage on average, whereas Setup is the strongest, suggesting that current agents are better at making pipelines executable than at verifying their reliability. Post-run error analysis further shows that verification and submission failures dominate tagged errors, accounting for 37.7% and 38.1% of fired codes respectively, whereas task-understanding errors are rare at 0.9%, and runs with one fired error code have a 48% lower overall score than runs with no error code on average.

cs.AI↗

arXiv2025

Cosmos-H-Surgical: Learning Surgical Robot Policies from Videos via World Modeling

Data scarcity remains a fundamental barrier to achieving fully autonomous surgical robots. While large scale vision language action (VLA) models have shown impressive generalization in household and industrial manipulation by leveraging paired video action data from diverse domains, surgical robotics suffers from the paucity of datasets that include both visual observations and accurate robot kinematics. In contrast, vast corpora of surgical videos exist, but they lack corresponding action labels, preventing direct application of imitation learning or VLA training. In this work, we aim to alleviate this problem by learning policy models from Cosmos-H-Surgical, a world model designed for surgical physical AI. We curated the Surgical Action Text Alignment (SATA) dataset with detailed action description specifically for surgical robots. Then we built Cosmos-H-Surgical based on the most advanced physical AI world model and SATA. It's able to generate diverse, generalizable and realistic surgery videos. We are also the first to use an inverse dynamics model to infer pseudokinematics from synthetic surgical videos, producing synthetic paired video action data. We demonstrate that a surgical VLA policy trained with these augmented data significantly outperforms models trained only on real demonstrations on a real surgical robot platform. Our approach offers a scalable path toward autonomous surgical skill acquisition by leveraging the abundance of unlabeled surgical video and generative world modeling, thus opening the door to generalizable and data efficient surgical robot policies.

cs.RO↗

arXiv2025

Auto3DSeg for Brain Tumor Segmentation from 3D MRI in BraTS 2023 Challenge

In this work, we describe our solution to the BraTS 2023 cluster of challenges using Auto3DSeg from MONAI. We participated in all 5 segmentation challenges, and achieved the 1st place results in three of them: Brain Metastasis, Brain Meningioma, BraTS-Africa challenges, and the 2nd place results in the remaining two: Adult and Pediatic Glioma challenges.

cs.CV↗

arXiv2025

Reasoning Visual Language Model for Chest X-Ray Analysis

Vision-language models (VLMs) have shown strong promise for medical image analysis, but most remain opaque, offering predictions without the transparent, stepwise reasoning clinicians rely on. We present a framework that brings chain-of-thought (CoT) reasoning to chest X-ray interpretation. Inspired by reasoning-first training paradigms, our approach is designed to learn how experts reason, not just what they conclude, by aligning intermediate steps with observable image evidence and radiology workflow. Beyond accuracy, the explicit reasoning traces support clinical auditability: they reveal why a conclusion was reached, which alternatives were considered, and where uncertainty remains, enabling quality assurance, error analysis, and safer human-AI collaboration. Our model couples high-fidelity visual encoding with a two-stage training recipe: a reasoning-style supervised fine-tuning (SFT) followed by reinforcement learning (RL) that uses verifiable rewards over a list of X-ray abnormalities. The model outputs reasoning that mirrors radiologists systematic thought process, uncertainty, and differential diagnosis. In out-of-distribution evaluation, the approach achieves competitive multi-label classification while improving interpretability. In a reader study with expert radiologists, full reasoning traces increased confidence, supported error auditing, and reduced time to finalize reports. We release code and the model NV-Reason-CXR-3B to support community progress toward trustworthy, explainable AI in chest radiography and other medical imaging tasks where reasoning quality is as critical as prediction quality.

cs.CV↗

arXiv2025

Towards the Automatic Segmentation, Modeling and Meshing of the Aortic Vessel Tree from Multicenter Acquisitions: An Overview of the SEG.A. 2023 Segmentation of the Aorta Challenge

The automated analysis of the aortic vessel tree (AVT) from computed tomography angiography (CTA) holds immense clinical potential, but its development has been impeded by a lack of shared, high-quality data. We launched the SEG.A. challenge to catalyze progress in this field by introducing a large, publicly available, multi-institutional dataset for AVT segmentation. The challenge benchmarked automated algorithms on a hidden test set, with subsequent optional tasks in surface meshing for computational simulations. Our findings reveal a clear convergence on deep learning methodologies, with 3D U-Net architectures dominating the top submissions. A key result was that an ensemble of the highest-ranking algorithms significantly outperformed individual models, highlighting the benefits of model fusion. Performance was strongly linked to algorithmic design, particularly the use of customized post-processing steps, and the characteristics of the training data. This initiative not only establishes a new performance benchmark but also provides a lasting resource to drive future innovation toward robust, clinically translatable tools.

cs.CV↗

arXiv2025

Training the next generation of physicians for artificial intelligence-assisted clinical neuroradiology: ASNR MICCAI Brain Tumor Segmentation (BraTS) 2025 Lighthouse Challenge education platform

High-quality reference standard image data creation by neuroradiology experts for automated clinical tools can be a powerful tool for neuroradiology & artificial intelligence education. We developed a multimodal educational approach for students and trainees during the MICCAI Brain Tumor Segmentation Lighthouse Challenge 2025, a landmark initiative to develop accurate brain tumor segmentation algorithms. Fifty-six medical students & radiology trainees volunteered to annotate brain tumor MR images for the BraTS challenges of 2023 & 2024, guided by faculty-led didactics on neuropathology MRI. Among the 56 annotators, 14 select volunteers were then paired with neuroradiology faculty for guided one-on-one annotation sessions for BraTS 2025. Lectures on neuroanatomy, pathology & AI, journal clubs & data scientist-led workshops were organized online. Annotators & audience members completed surveys on their perceived knowledge before & after annotations & lectures respectively. Fourteen coordinators, each paired with a neuroradiologist, completed the data annotation process, averaging 1322.9+/-760.7 hours per dataset per pair and 1200 segmentations in total. On a scale of 1-10, annotation coordinators reported significant increase in familiarity with image segmentation software pre- and post-annotation, moving from initial average of 6+/-2.9 to final average of 8.9+/-1.1, and significant increase in familiarity with brain tumor features pre- and post-annotation, moving from initial average of 6.2+/-2.4 to final average of 8.1+/-1.2. We demonstrate an innovative offering for providing neuroradiology & AI education through an image segmentation challenge to enhance understanding of algorithm development, reinforce the concept of data reference standard, and diversify opportunities for AI-driven image analysis among future physicians.

cs.LG↗

arXiv2024

VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data$-$features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

cs.CV↗

arXiv2024

A Short Review and Evaluation of SAM2's Performance in 3D CT Image Segmentation

Since the release of Segment Anything 2 (SAM2), the medical imaging community has been actively evaluating its performance for 3D medical image segmentation. However, different studies have employed varying evaluation pipelines, resulting in conflicting outcomes that obscure a clear understanding of SAM2's capabilities and potential applications. We shortly review existing benchmarks and point out that the SAM2 paper clearly outlines a zero-shot evaluation pipeline, which simulates user clicks iteratively for up to eight iterations. We reproduced this interactive annotation simulation on 3D CT datasets and provided the results and code~\url{https://github.com/Project-MONAI/VISTA}. Our findings reveal that directly applying SAM2 on 3D medical imaging in a zero-shot manner is far from satisfactory. It is prone to generating false positives when foreground objects disappear, and annotating more slices cannot fully offset this tendency. For smaller single-connected objects like kidney and aorta, SAM2 performs reasonably well but for most organs it is still far behind state-of-the-art 3D annotation methods. More research and innovation are needed for 3D medical imaging community to use SAM2 correctly.

cs.CV↗

arXiv2024

VISTA3D: A Unified Segmentation Foundation Model For 3D Medical Imaging

Foundation models for interactive segmentation in 2D natural images and videos have sparked significant interest in building 3D foundation models for medical imaging. However, the domain gaps and clinical use cases for 3D medical imaging require a dedicated model that diverges from existing 2D solutions. Specifically, such foundation models should support a full workflow that can actually reduce human effort. Treating 3D medical images as sequences of 2D slices and reusing interactive 2D foundation models seems straightforward, but 2D annotation is too time-consuming for 3D tasks. Moreover, for large cohort analysis, it's the highly accurate automatic segmentation models that reduce the most human effort. However, these models lack support for interactive corrections and lack zero-shot ability for novel structures, which is a key feature of "foundation". While reusing pre-trained 2D backbones in 3D enhances zero-shot potential, their performance on complex 3D structures still lags behind leading 3D models. To address these issues, we present VISTA3D, Versatile Imaging SegmenTation and Annotation model, that targets to solve all these challenges and requirements with one unified foundation model. VISTA3D is built on top of the well-established 3D segmentation pipeline, and it is the first model to achieve state-of-the-art performance in both 3D automatic (supporting 127 classes) and 3D interactive segmentation, even when compared with top 3D expert models on large and diverse benchmarks. Additionally, VISTA3D's 3D interactive design allows efficient human correction, and a novel 3D supervoxel method that distills 2D pretrained backbones grants VISTA3D top 3D zero-shot performance. We believe the model, recipe, and insights represent a promising step towards a clinically useful 3D foundation model. Code and weights are publicly available at https://github.com/Project-MONAI/VISTA.

cs.CV↗

arXiv2024

A Robust Ensemble Algorithm for Ischemic Stroke Lesion Segmentation: Generalizability and Clinical Utility Beyond the ISLES Challenge

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

eess.IV↗

arXiv2024

Multi-Center Fetal Brain Tissue Annotation (FeTA) Challenge 2022 Results

Segmentation is a critical step in analyzing the developing human fetal brain. There have been vast improvements in automatic segmentation methods in the past several years, and the Fetal Brain Tissue Annotation (FeTA) Challenge 2021 helped to establish an excellent standard of fetal brain segmentation. However, FeTA 2021 was a single center study, and the generalizability of algorithms across different imaging centers remains unsolved, limiting real-world clinical applicability. The multi-center FeTA Challenge 2022 focuses on advancing the generalizability of fetal brain segmentation algorithms for magnetic resonance imaging (MRI). In FeTA 2022, the training dataset contained images and corresponding manually annotated multi-class labels from two imaging centers, and the testing data contained images from these two imaging centers as well as two additional unseen centers. The data from different centers varied in many aspects, including scanners used, imaging parameters, and fetal brain super-resolution algorithms applied. 16 teams participated in the challenge, and 17 algorithms were evaluated. Here, a detailed overview and analysis of the challenge results are provided, focusing on the generalizability of the submissions. Both in- and out of domain, the white matter and ventricles were segmented with the highest accuracy, while the most challenging structure remains the cerebral cortex due to anatomical complexity. The FeTA Challenge 2022 was able to successfully evaluate and advance generalizability of multi-class fetal brain tissue segmentation algorithms for MRI and it continues to benchmark new algorithms. The resulting new methods contribute to improving the analysis of brain development in utero.

eess.IV↗

arXiv2023

Automated 3D Segmentation of Kidneys and Tumors in MICCAI KiTS 2023 Challenge

Kidney and Kidney Tumor Segmentation Challenge (KiTS) 2023 offers a platform for researchers to compare their solutions to segmentation from 3D CT. In this work, we describe our submission to the challenge using automated segmentation of Auto3DSeg available in MONAI. Our solution achieves the average dice of 0.835 and surface dice of 0.723, which ranks first and wins the KiTS 2023 challenge.

cs.CV↗

arXiv2023

Aorta Segmentation from 3D CT in MICCAI SEG.A. 2023 Challenge

Aorta provides the main blood supply of the body. Screening of aorta with imaging helps for early aortic disease detection and monitoring. In this work, we describe our solution to the Segmentation of the Aorta (SEG.A.231) from 3D CT challenge. We use automated segmentation method Auto3DSeg available in MONAI. Our solution achieves an average Dice score of 0.920 and 95th percentile of the Hausdorff Distance (HD95) of 6.013, which ranks first and wins the SEG.A. 2023 challenge.

eess.IV↗

arXiv2023

The state-of-the-art 3D anisotropic intracranial hemorrhage segmentation on non-contrast head CT: The INSTANCE challenge

Automatic intracranial hemorrhage segmentation in 3D non-contrast head CT (NCCT) scans is significant in clinical practice. Existing hemorrhage segmentation methods usually ignores the anisotropic nature of the NCCT, and are evaluated on different in-house datasets with distinct metrics, making it highly challenging to improve segmentation performance and perform objective comparisons among different methods. The INSTANCE 2022 was a grand challenge held in conjunction with the 2022 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). It is intended to resolve the above-mentioned problems and promote the development of both intracranial hemorrhage segmentation and anisotropic data processing. The INSTANCE released a training set of 100 cases with ground-truth and a validation set with 30 cases without ground-truth labels that were available to the participants. A held-out testing set with 70 cases is utilized for the final evaluation and ranking. The methods from different participants are ranked based on four metrics, including Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), Relative Volume Difference (RVD) and Normalized Surface Dice (NSD). A total of 13 teams submitted distinct solutions to resolve the challenges, making several baseline models, pre-processing strategies and anisotropic data processing techniques available to future researchers. The winner method achieved an average DSC of 0.6925, demonstrating a significant growth over our proposed baseline method. To the best of our knowledge, the proposed INSTANCE challenge releases the first intracranial hemorrhage segmentation benchmark, and is also the first challenge that intended to resolve the anisotropic problem in 3D medical image segmentation, which provides new alternatives in these research fields.

eess.IV↗

arXiv2022

MONAI: An open-source framework for deep learning in healthcare

Artificial Intelligence (AI) is having a tremendous impact across most areas of science. Applications of AI in healthcare have the potential to improve our ability to detect, diagnose, prognose, and intervene on human disease. For AI models to be used clinically, they need to be made safe, reproducible and robust, and the underlying software framework must be aware of the particularities (e.g. geometry, physiology, physics) of medical data being processed. This work introduces MONAI, a freely available, community-supported, and consortium-led PyTorch-based framework for deep learning in healthcare. MONAI extends PyTorch to support medical data, with a particular focus on imaging, and provide purpose-specific AI model architectures, transformations and utilities that streamline the development and deployment of medical AI models. MONAI follows best practices for software-development, providing an easy-to-use, robust, well-documented, and well-tested software framework. MONAI preserves the simple, additive, and compositional approach of its underlying PyTorch libraries. MONAI is being used by and receiving contributions from research, clinical and industrial teams from around the world, who are pursuing applications spanning nearly every aspect of healthcare.

cs.LG↗

arXiv2022

NVIDIA FLARE: Federated Learning from Simulation to Real-World

Federated learning (FL) enables building robust and generalizable AI models by leveraging diverse datasets from multiple collaborators without centralizing the data. We created NVIDIA FLARE as an open-source software development kit (SDK) to make it easier for data scientists to use FL in their research and real-world applications. The SDK includes solutions for state-of-the-art FL algorithms and federated machine learning approaches, which facilitate building workflows for distributed learning across enterprises and enable platform developers to create a secure, privacy-preserving offering for multiparty collaboration utilizing homomorphic encryption or differential privacy. The SDK is a lightweight, flexible, and scalable Python package. It allows researchers to apply their data science workflows in any training libraries (PyTorch, TensorFlow, XGBoost, or even NumPy) in real-world FL settings. This paper introduces the key design principles of NVFlare and illustrates some use cases (e.g., COVID analysis) with customizable FL workflows that implement different privacy-preserving algorithms. Code is available at https://github.com/NVIDIA/NVFlare.

cs.LG↗

arXiv2022

Automated head and neck tumor segmentation from 3D PET/CT

Head and neck tumor segmentation challenge (HECKTOR) 2022 offers a platform for researchers to compare their solutions to segmentation of tumors and lymph nodes from 3D CT and PET images. In this work, we describe our solution to HECKTOR 2022 segmentation task. We re-sample all images to a common resolution, crop around head and neck region, and train SegResNet semantic segmentation network from MONAI. We use 5-fold cross validation to select best model checkpoints. The final submission is an ensemble of 15 models from 3 runs. Our solution (team name NVAUTO) achieves the 1st place on the HECKTOR22 challenge leaderboard with an aggregated dice score of 0.78802.

eess.IV↗